AMA: New 2023 CPT code set includes burden-reducing revisions

Building on its efforts to reduce administrative tasks in medicine—a driver of burnout and a central pillar of its Recovery Plan for America’s Physicians—the American Medical Association (AMA) released the 2023 Current Procedural Terminology (CPT) code set. The nation’s leading data-sharing terminology for medical procedures and services, the 2023 CPT code set contains burden-reducing revisions to the codes and guidelines for most evaluation and management (E/M) services.

Based on the 2021 revisions made to the E/M codes for office visit services, the new modifications make coding and documentation easier and more flexible for other E/M services, freeing physicians and care teams from time-wasting administrative tasks that are clinically irrelevant to providing high-quality care to patients. The new modification to the E/M codes extend to inpatient and observation care services, consultations, emergency department services, nursing facility services, home and residence services, and prolonged services.

“The process for coding and documenting almost all E/M services is now simpler and more flexible,” said AMA President Jack Resneck Jr., M.D. “We want to ensure that physicians and other users get the full benefit of the administrative relief from the E/M code revisions. The AMA is helping physicians and health care organizations prepare now for the E/M coding changes and offers authoritative resources to anticipate the operational, infrastructural and administrative workflow adjustments that will result from the pending transition.”

The AMA has developed an extensive online resource library of videos, guides, and educational modules to help with the transition to the revised E/M codes and guidelines. Please visit the Implementing CPT Evaluation and Management (E/M) revisions web page for a complete list of AMA resources.

Other changes to the CPT code set

Modifications to the E/M codes are among 393 editorial changes in the 2023 CPT code set, including 225 new codes, 75 deletions and 93 revisions. With 10,969 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology.

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel, an independent body convened by the AMA that collects broad input from the health care community and beyond to ensure CPT content reflects the coding and data-driven demands of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.

Responding to the fast pace of innovation, a new appendix has been added to the 2023 CPT code set with a taxonomy for artificial intelligence/augmented intelligence (AI) applications. The new AI taxonomy provides guidance for classifying various AI-powered medical service applications, such as expert systems, machine learning, or algorithm-based solutions, into one of three categories: assistive, augmentative, or autonomous.

“The new AI taxonomy establishes foundational definitions and a shared understanding among stakeholders that clearly describes the technical features and performance of AI applications, as well as the work performed by the machine on behalf of the health care professional,” said Dr. Resneck. “This shared understanding will help guide the CPT editorial process for describing the range of AI products and services.”

Other important additions to the 2023 CPT code set respond to new medical services sparked by emerging uses of virtual reality technology in therapy (0770T) used for skill-building for social communication, emotional regulation, and daily functional skills in people with neurodevelopmental disorders, as well as procedural dissociation services (0771T-0777T) used in place of anesthesia during procedures to increase tolerance and reduce pain and anxiety.

The list of CPT codes for remote monitoring services continues to grow with the addition of a new code to report cognitive behavior therapy monitoring (98978) beyond the walls of a medical practice for a range of physical and mental health disorders.

The evolution of new medical techniques and technology also prompted the creation of 15 new CPT codes (49591-49623) to report anterior abdominal hernia repair services. The update addresses correct reporting for “hybrid” abdominal hernia repair procedures where parts of the procedure are perform via an open approach and parts of the procedure are performed via laparoscopy or with the use of a robot.

CPT content & resources

To assist the health care system in an orderly annual transition to a newly modified CPT code set, the AMA releases each new edition four months ahead of the Jan. 1 operational date and develops an insider’s view with detailed information on the new changes in the 2023 CPT code set.

The AMA invites the health care community to stay up to date on the significant CPT code changes for 2023 by attending two virtual events this November, the Outpatient CDI Workshop and the CPT and RBRVS Annual Symposium. Meeting agendas and registration are available on the AMA website.

For more information, a special section for CPT education has been created for the AMA Ed Hub, an online learning platform containing CME and education, including a module series covering an overview of CPT coding basics and other topics. The CPT Network is also available for authoritative CPT coding guidance.

Coding books and products are available from the AMA Storefront on Amazon, including the CPT Professional 2023 codebook with updated medical illustrations to represent the full diversity and identities of the people in our society. Continued updates to the illustrations represent one step in the AMA’s collective efforts to equip all physicians and health care workers with the tools and resources needed to ensure inclusion and belonging, as well as to advance equity.

The 2023 CPT codes and descriptors can be imported straight into existing health care software solutions using the downloadable CPT 2023 Data File. The data file contains the updated code set’s complete descriptor package, including descriptors for consumers and physicians, and the complete official CPT coding guidelines

AMA, American Medical Association, CPT codes, Current Procedural Terminology, Implementing CPT Evaluation and Management (E/M) revisions

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